Governments urged to invest in healthcare systems despite global economic uncertainty

By Integrated Care Journal

There is an urgent need to invest in healthcare systems to build resilience against future crises and the growing burden of disease, according to new research presented at a Global Summit on 22nd November.

The research, commissioned by the Partnership for Health System Sustainability and Resilience (PHSSR), highlights the need for Governments around the world to address weaknesses in healthcare services which leave countries exposed to crises and increase the economic, social and environmental impact of disease.

The PHSSR, of which the London School of Economics and Political Science (LSE) is a founding member, is a collaboration between businesses, academic, non-governmental, life sciences and healthcare organisations. The Partnership aims to study and help build health systems that are resilient to crises and sustainable in the face of long-term stresses.

Commenting on the crisis facing healthcare systems globally, Dr. Shyam Bishen, Head of Health & Healthcare at the World Economic Forum, said: “Healthcare systems around the world are grappling with the same problems, delivering services amid resource constraints and increased demand. Amid aging and growing populations, rises in non-communicable diseases and the impacts of climate change, there is one thing that remains certain – the need to continue investing in our health systems.”

The research examined domestic healthcare systems in 13 countries* using a framework designed by LSE academics. The findings highlight the following weaknesses:

Healthcare systems are underfinanced and the financing mechanisms in place are often ineffective and do not incentivise better health outcomes.
Health services are grappling with staffing shortages and wellbeing issues. In addition, healthcare workforces are inequitably distributed, impacting their capacity to meet needs. In particular this affects people in rural areas, underprivileged and marginalised groups, and those with chronic conditions.
In many of the countries studied, providing coordinated and proactive care remains a challenge. Investments in primary care, prevention and health promotion also tend to be low.
Inequities are pervasive in healthcare and have deepened during COVID-19. Equally the social determinants of health remain under-emphasised in national policies.
Despite the fact human and climate health are inextricably linked, many healthcare systems are struggling to understand, monitor and take action to reduce their environmental impact, and adequately protect their populations from the health impacts of climate change.
Among the countries researched, there is a wide variation in the availability, completeness, and use of health data to drive evidence-informed decision making, policy evaluation and learning. Interoperability of disparate electronic health records systems is also a key challenge in many countries.

Commenting on the findings, Baroness Minouche Shafik, Director of the London School of Economics and Political Science said: “Health systems are there to protect us. They are one of the foundations of a healthy society and a prosperous economy. When a crisis hits, we need them to stand firm. We cannot repeat the same mistakes from the post-2008 financial crisis era which left health systems ill-prepared to deal with COVID-19 and the ever-rising burden of chronic diseases.

“Maximum efforts should therefore be taken to ensure that health systems are made more resilient to future crises, and in turn sustainable in the face of long-term pressures.”

The research also highlighted the importance of collaboration to build more resilient and sustainable health systems. Exchanging knowledge with other sectors and across borders can accelerate improvements and strengthen healthcare systems.

Through its work, the PHSSR and its partners collaborate to build knowledge and guide action through research reports that offer evidence-informed policy recommendations to improve the sustainability and resilience of healthcare systems.

The PHSSR was established in 2020 by the London School of Economics, the World Economic Forum, and AstraZeneca, who were later joined by global-level partners that include Philips, KPMG, the Center for Asia-Pacific Resilience and Innovation (CAPRI) and the WHO Foundation.

This new research builds on evidence gained through an earlier round of work in 2021 that studied health systems in an initial group of eight countries.** Findings from a specific regional cohort, CEEBA Health Policy Network, looking into the Central Eastern Europe and Baltics area will also be presented and discussed at the Global Summit. The new country reports and an overarching summary report will be published between now and March 2023. All research reports are available on the PHSSR website.

* Countries include: Belgium, Brazil, Canada, Egypt, Greece, India, Ireland, Japan, Portugal, the Netherlands, Saudi Arabia, Switzerland, and the United Arab Emirates.

** Countries include: England, France, Germany, Italy, Poland, Russia, Spain and Vietnam.

State of social care and support provision has not improved, new report suggests

By Integrated Care Journal

Care England, as a member of the Care Provider Alliance, which brings together the main national associations that represent independent and voluntary adult social care providers in England, published a report on the current state of social care in England this week.

The Care Provider Alliance (CPA) published a briefing this week, The State of the Social Care and Support Provision in England, that highlights the key issues currently afflicting the social care sector. These issues include, but are not limited to:

· The rising cost of living

· Lack of funding to Local Authorities to adequately raise fee rates for social care

· Impact of financial pressures and uncertainty

· Unmet need is unacceptably high and rising

The key message from the report is that immediate government investment into social care is needed now. Without substantial reform and investment to support that reform, achieving long-term sustainability is impossible in the current economic climate. The implication of continued governmental inaction is continued market instability. Provider failure will impact significantly on both the NHS and Local Authorities, who will be unable to commission care and support packages from providers. Lack of action now will also prevent care providers from enabling those who rely on care support to enjoy their rights to live purposeful lives, as active members of families and communities.

Professor Martin Green, Chief Executive of Care England, said: “We require a 1948 moment for adult social care to establish a long-term and sustainable future that will be to the benefit of all citizens and the economy. It is clear that the reforms introduced under the Johnson administration are a starting point but are by no means going to ‘fix social care’ and the current reform proposals may well be kicked into the long grass again.

“The sector stands ready and willing to support the delivery of a much-needed reform agenda that will deliver a clear funding strategy for social care, whilst also developing a range of careers and opportunities that will provide high-quality care and support local economic development. The health of the UK economy cannot be separated from the health of the social care sector, the two are fundamentally linked.”

The report comes after Care England accused Ofgem of predatory pricing by charging “horrendous and financially crippling rates” in an open letter. Care England, the country’s largest representative body for independent providers of adult social care in England, is calling on the government to launch an investigation into the matter.

Lack of self-care confidence putting pressure on frontline NHS services

By Integrated Care Journal

Study finds one in five do not feel confident treating a headache themselves, and a third would be uncertain about treating a minor burn.

A real-world research poll of more than 2,000 UK adults reveals an alarming lack of confidence and knowledge around self-care for everyday ailments and highlights the threat this poses to struggling frontline health services. The poll, conducted by consumer healthcare association, PAGB, finds that one in five people do not feel confident treating a headache themselves, almost a quarter would not be comfortable self-treating a sore throat and a third would be uncertain about how to treat a minor burn.

Yet, despite the difficulty many consumers face getting GP appointments, there has been a fall in the number of people seeking advice from pharmacists for common ailments. Fewer than half (44 per cent) now turn to these highly qualified health professionals for initial advice, compared to 47 per cent last year.

Deborah Evans, community pharmacist and an advisor to PAGB, said: “These shocking findings show we need to get people back into their community pharmacies and talking to their pharmacist. Pharmacists train to qualify for five years and can help provide expert advice on all self-treatable conditions including minor cuts and burns to aches and pains.

“Pharmacists are well placed to drive a holistic approach to self-care. They can help to advise people on the most suitable and effective over-the-counter treatments as well as self-care techniques.”

However, the PAGB research reveals a worrying lack of knowledge or self-belief among the public when it comes to treating common conditions themselves. Statistics showing how many lack the confidence to self-treat everyday ailments are alarming:

• Conjunctivitis: 73 per cent

• Warts or veruccas: 61 per cent

• Backache: 52 per cent

• Nose bleeds: 45 per cent

• Cold sores: 40 per cent

• Heartburn or indigestion: 38 per cent

• Minor burns: 34 per cent

• Diarrhoea: 33 per cent

• Sore throat: 25 per cent

• Headache: 23 per cent

• Coughs: 18 per cent

Deborah Evans added: “These are all instances where a pharmacist can help and seeking advice from these highly qualified and easily accessible experts ensures consumers get swift treatment and precious NHS resources can be focused on more serious conditions. The potential savings are enormous. In 2020, it was estimated that the average GP consultation cost the NHS £39.32, and the most basic A&E was at least £77.”

Michelle Riddalls, CEO of PAGB, who carried out the research warned: “Our real-world research study presents an urgent call to action for the Government. Even before the pandemic, there were an estimated 18 million GP appointments and 3.7 million A&E visits every year for conditions which people could have treated themselves or for which a pharmacist should have been the first port of call.

“With the increasing pressures over recent years it is clear that the NHS cannot afford to let this continue.

“During the pandemic, we saw a coordinated campaign by NHS England and the Department of Health and Social Care to encourage consumers to stay at home and self-treat. As a result, this had a positive effect on both people’s confidence and ability to self-treat. We need to replicate this for all self-treatable conditions, and this can only be achieved via a national policy on self-care.”

NHS elective and cancer backlog plan “at serious risk”, warns NAO

By Integrated Care Journal and Gabriel Blaazer

National Audit Office warns plans to reduce long waits for NHS elective and cancer care services by 2025 at risk, citing the failure of funding to keep pace with inflation and deeply-rooted workforce and productivity issues.

In December 2021, the NAO reported that at the start of the COVID-19 pandemic, the NHS had not met its standard for elective care for four years, nor its full set of eight standards for cancer services for six years. Over the course of the pandemic, the waiting list for elective care grew from 4.4 million in February 2020 to 5.8 million by September 2021, and currently stands at more than 7 million.

In February 2022, NHS England (NHSE) published a plan to recover elective and cancer care (the recovery plan) over the three years up to March 2025, with the Department for Health and Social Care (DHSC) funding the recovery plan and responsible for holding NHSE to account.

NHSE’s intention is that the number of patients waiting more than 62 days for treatment from an urgent referral for cancer care should return to pre-pandemic levels by March 2023. They also hope to eliminate all elective care waits of more than one year by March 2025.

However, even if the objectives of the recovery plan are met, many patients will still be waiting longer than the NHS Constitution’s standards allow – elective care patients should start their treatment within 18 weeks, and cancer patients within 62 days of an urgent referral by their GP.

Elective care failing to bounce back

NHSE is aiming to increase elective care activity sharply to reach 129 per cent of 2019-20 levels in 2024-25. This would be an historic achievement – it previously took 5 years (2013-14 to 2018-19) to increase elective activity by 18 per cent. Even if NHSE meets this aim, it is unclear whether increasing elective activity to 129 per cent would be sufficient to meet the other commitments in the recovery plan.

During 2022-23 so far, overall elective care activity has remained below the planned trajectory for reaching 129 per cent of 2019-20 levels by 2024-25. By July 2022, the NHS came close to ending elective care waits of more than two years, but the waiting list has continued to increase – reaching 7.0 million patients in August 2022.

This includes 387,000 patients who have already waited longer than a year for treatment, compared with just 1,600 in February 2020. 26 of the 42 NHS integrated care systems have signalled in their plans that they will not reach their 2022-23 target of delivering 104 per cent of 2019-20 levels of elective care activity.

Increasing diagnostic capacity

NHSE’s programme to recover elective care partly relies on initiatives which have potential but for which there is so far limited evidence of effectiveness. It wants GPs to handle many elective cases usually referred to hospital doctors. This might add to GPs’ workload in the context of a 4 per cent decrease in the fully-qualified permanent GP workforce between 2017 and 2022.

Surgical hubs and community diagnostic centres can contribute to recovery, but their impact will need to be closely monitored – capacity could be reduced if their host hospital or other NHS and social care services in their local area come under pressure.

Urgent referrals for suspected cancer have increased compared with 2019-20, but the NHS is not treating all cancer patients in a timely way. Between April and August 2022, GPs urgently referred 15 per cent more people with suspected cancer than in the same period in 2019.

The welcome increase in patients coming forward has, however, highlighted the inadequacy of current diagnostic and treatment capacity. In 2022-23 up to the end of August, only 62 per cent of patients started cancer treatment within 62 days, compared with 78 per cent of patients in the equivalent period in 2019-20.

Funding and productivity

Inflation has eroded the value of both the £14 billion specifically allocated to the recovery plan and the wider planned increases in NHSE’s budget. In the October 2021 Budget, NHSE was allocated an additional £8 billion of resource and £5.9 billion of capital funding for the recovery plan for the period 2022-23 to 2024-25.

At that time, the total NHSE funding settlement provided for average annual real terms growth of 3.8 per cent in resource funding up to 2024-25. But the NAO estimates that, as at September 2022, this settlement represented an average annual growth in funding of just 3.3 per cent in real terms because of higher forecast inflation.

NHSE estimates that in 2021, productivity in the NHS was 16 per cent lower than before the COVID-19 pandemic and has continued to decline in 2022-23. Some of this stems directly from the pandemic, such as increased sickness absence and infection prevention and control measures. An internal NHSE review identified a range of other causes including reduced willingness to work paid or unpaid overtime.

However, organisations that represent NHS workers, including NHS Providers, point out that increasing workloads, burnout among staff and cost-of-living concerns are impacting the ability of healthcare staff to carry out their duties effectively.

There are many challenges threatening to push the recovery plan further off track, including high numbers of unfilled posts and low morale among the NHS workforce. The NAO recommends that DHSC and NHSE review the progress of the recovery plan in early 2023-24, and decide whether targets and funding allocations need to be adjusted.

They add that before April 2023, DHSC and NHSE should clearly and fully define metrics for increasing activity and reducing long waits. In 2024-25, they should publish a strategy for returning elective and cancer care services to a state where legal standards are met, the NAO recommends.

Gareth Davies, the head of the NAO, said: “There are significant risks to the delivery of the plan to reduce long waits for elective and cancer care services by 2025. The NHS faces workforce shortages and inflationary pressures, and it will need to be agile in responding as the results of different initiatives in the recovery programme emerge.

“DHSC has an essential role to play, holding the NHS to account for its delivery of the recovery plan and providing more challenge and support when it is needed.”

In response to the NAO’s warnings, the Interim Chief Executive of NHS Providers, Saffron Cordery, said: ““The NAO’s warning follows our own findings that fewer than half of NHS trusts expect to meet key end-of-year elective recovery and cancer targets.

“The NAO rightly highlights ‘significant workforce and productivity issues’ facing the NHS and that government funding to help clear backlogs hasn’t kept pace with double-digit inflation.

“NHS trust leaders and their staff continue to pull out all the stops to bear down on backlogs in the face of demand for services even higher than before COVID-19. They have slashed the longest waits for treatment and are exceeding pre-pandemic activity in many areas. Mental health services are in contact with record numbers of people and community services are doing their utmost to reduce a waiting list estimated at more than one million.

“But making further headway is hard due to long-standing, fundamental pressures which persist right across the NHS, especially chronic staff shortages and severely stretched budgets.

“With more than 130,000 vacancies across NHS trusts the government must produce urgently a fully costed and funded workforce plan so that the NHS can recruit and retain the people it so desperately needs to give patients first-class care.

News, Tunstall Healthcare November 15, 2022

Using integrated care to live healthier and happier lives

By Angus Honeysett

Angus Honeysett, Head of Market Access at Tunstall Healthcare, discusses putting citizens at the heart of care through technology, partnerships and integrated care to enable people to live happier, healthier lives.

The Government’s white paper, People at the Heart of Care, has a clear focus on integration and recognising the vital importance of improving quality of life and health outcomes. In particular, it promises £150 million of funding for several key areas, including assistive technology; improving the establishment and maintenance of digital records and data; upskilling the adult social care workforce in how to use technology; and bedding in wider digital infrastructure and cybersecurity within systems.

This is translated into the core objectives of integrated care systems (ICSs) as greater integration and more funding will enable them to facilitate the delivery of high-quality local services and citizen-focused outcomes.

The system will operate at three levels – integrated care partnerships, integrated care boards, and provider collaboratives – building better system-level knowledge of the needs of people so that they can receive more support closer to home, which includes some outpatient and diagnostic procedures.

People can stay independent for longer because health providers and community-based services will support those with the most complex needs outside of hospital settings. As the work of ICSs begins, now is a pivotal time that will shape our resources for decades to come.

Technology and cultural change

As ICSs continue to develop, the focus on driving digital systems that place citizens at the centre of service design and delivery will increase. Yet to deploy technology effectively, there are significant cultural challenges to overcome.

Technology has historically been seen as an addition to existing resources – a ‘nice-to-have’, rather than a means of transforming models of support. This has led to difficulties in integrating technology effectively. Cultural change is required which in turn needs early engagement.

Top-down leadership is needed to ensure stakeholders have input at an early stage into how technology can help them and the citizens they support. There are still workforce concerns that need to be addressed and stakeholders need to understand that technology is an enabler for better services, not a replacement for human contact.

Using technology to support people can be low-cost, thereby enabling more people to have digital solutions integrated into their care provision. This in turn gives professionals the ability to provide preventative care and engage with citizens so that they can stay at home for longer with an increased quality of life. Likewise, relatively low-cost telecare systems can help to avoid hospital admission and delay and prevent the need for residential care, and reduce carer burnout.

Understanding the barriers that we face and adapting as things change – not being driven by contracts, but by providing solutions – will ensure innovation continues to flourish. To successfully build solutions however, healthcare services must first understand the problems that are faced by people on a daily basis, with the recognition that this will change between individuals. The more we understand these problems, the easier it will be to co-design straightforward and effective strategies and solutions.

Technology is a quick win for ICSs and if used effectively, can free up the time for the workforce and other stakeholders, enabling them to become more productive in providing support to citizens that need it most.

The aim should be to embed technology so that outcomes are at the centre of all support that is provided, instead of endless form-filling, unnavigable processes and a bureaucracy which sees too many people get lost in the system, rather than receiving the support they need. It puts both power and opportunity in the hands of citizens and communities, providing solutions that are easy and efficient to access.

Collaboration and integration

Working together is in the interests of the public and all stakeholders, and greater integration, co-design and uptake of technology will enable an increase and improvement in the solutions that are available. This will also ensure that services can meet the population’s needs, saving taxpayers’ money through cost-avoidance to the system.

The formation of ICSs provides a unique opportunity to consider and pursue shared common goals. Health and social care must work together to have a positive and long-lasting impact on population health, to ensure citizens are at the heart of decisions about the support they need.

Our services are all intrinsically dependent upon each other which is reflected in the establishment of ICSs. If care delivery is ineffective, it places increased pressure on our health system, therefore leading to an inability to support citizens. Healthcare services need to have a truly joined up, integrated approach where they listen, understand everyday needs and work together to bridge gaps in resource allocation, including funding flow, which needs continued reform to drive system change.

When we deliver successful and integrated services, the benefits flow through the system from primary to secondary care, to community and social care. With the right approach, citizens can stay in the place of their choice for longer, delaying the requirement for more expensive and complex solutions.

Empowerment and control

The UK’s ageing population means there is little choice but to look at alternative ways to deliver support, in order to cope with increasing demand and more complex needs. The increased integration of technology and its use not only enhances the care that people receive, but also enables them to remain at home for longer, increasing the efficiency and capacity of our systems.

As we continue to invest and integrate technology into our services, it gives citizens greater ability to become more involved in how their health and wellbeing is managed. Data plays a particularly important role in empowering citizens to manage their own conditions as through technology such as telehealth, they can take their own readings and share these with the right people at the right time.

For citizens to be fully empowered, they must be engaged with and made a part of decision making around their care, and also understand the benefits that technology can bring, alongside how to use it.

Through the use of clear language, healthcare systems can communicate more effectively with citizens and build links between the technology that they already have and regularly use, and the technology that can support their health and wellbeing through new services. This in turn should reduce fear of the unknown and help drive a culture change at both local authority and citizen level.

By integrating services through ICSs and investing in the next generation of technology, it’s easier to engage families, friends, and communities in supporting early, proactive, and preventative interventions. Digital innovation presents opportunities to improve citizen experience, supporting better quality and greater reliability of service provision, providing enhanced solutions which are tailored to meet specific needs.

Looking to the future

ICSs and their development provide a timely opportunity to revolutionise our health systems and put citizens at the heart of care through the delivery of better outcomes and cost reductions. However, challenges remain, such as the UK’s move from analogue to digital communications networks.

This will require significant investment from the public sector at a time when budgets are already under extreme pressure, however, this brings a once in a generation opportunity to modernise, improve and shift thinking from a reactive, to a proactive delivery model. AI, machine learning and the use of data are hugely important to this.

Using data in a proactive and predictive way means issues can be highlighted early, which is in everyone’s best interest. The more that citizens are involved and engaged with data, including taking their own readings, the more they’ll understand how to more effectively manage their health and wellbeing on a daily basis.

By educating service professionals and the public on the value of data and how it can be used to transform health and care provision, people will become more comfortable with their data being used in a real-time setting.

With increased funding, improved decision making through ICSs, and better integration of technology, we will be able to drive reconfiguration and collaboration. It’s essential that service providers and citizens are involved in the digital transformation if we’re to innovate, embrace technology fully and successfully, and deliver new approaches which create benefits for both citizens and the system.

This article was kindly sponsored by Tunstall Healthcare.

For more information, please visit www.tunstall.co.uk.

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Energy cost support resource launched for care workers

By Integrated Care Journal

As social care workers and providers grapple with sharply rising energy costs this winter, Community Integrated Care has launched a new programme to support social care workers, people using services and family carers.

Free to access and available to all, Taking Charge offers free interactive webinars and accessible resources, specially tailored to the home-life and working routines of people who work in social care, and the people they support.

Launched by Community Integrated Care, a member of the National Care Forum (NCF), it brings together expert advice from leading energy organisations with the insights and perspectives shaped by the people it supports and their colleagues.

The ongoing energy crisis, coupled with spiralling inflation, is seeing many social care workers and their families struggle financially, and many disabled people are paying more than double the energy bill of the average consumer.

The NCF has been drawing attention to the growing energy pressures and its impact on the sector, alongside the ongoing workforce shortages, for several months, and has called on the government for:

A guarantee that adult social care providers are defined as a vulnerable sector as part of the Energy Bill Relief Scheme following April 2023.
A guarantee that those people accessing adult social care support will be able to access the Energy Price Guarantee following April 2023.
Additional, immediate support for providers to reduce the pressures facing social care workers and meet other operational costs due to rising cost of living and inflation

Professor Vic Rayner OBE, CEO of NCF, said: “The eye watering increases in energy costs is a very serious concern among our members, even after the government capped prices through the Energy Bill Relief and Energy Price Guarantee Schemes.

“For social care workers, the steep rises in the cost of living and energy costs alongside the continued reluctance of government to guarantee the funding for better pay, terms and conditions, means that the next few months will be very hard.

“The lives and wellbeing of the people who access care and support services are also significantly impacted, and many are not enjoying the same support the government is giving to other households.

“It’s encouraging to see such an innovative, co-produced, support programme from Community Integrated Care. This will provide much needed practical support to people accessing care services and care workers. However, this can’t be the responsibility of providers alone, we also need more action from government.”

Latest obesity figures for England show a strong link between children living with obesity and deprivation

By Integrated Care Journal

Findings from annual health report on children’s health by NHS Digital reveals a strong correlation between obesity and deprivation of living conditions.

The National Child Measurement Programme (NCMP) – overseen by the Office for Health Improvement and Disparities and analysed and reported by NHS Digital – measures the height and weight of children in England annually and provides data on the number of children in Reception (4-5 years) and Year 6 (10-11 years) who are underweight, healthy weight, overweight, living with obesity or living with severe obesity.

NHS Digital recently published the NCMP England – 2021-22 report which discovered that children living in the most deprived areas were more than twice as likely to be living with obesity, than those living in the least deprived areas.

Indeed, the prevalence of severe obesity was over three times as high for children aged 4-5 years living in the most deprived areas (4.5 per cent) compared with those living in the least deprived areas (1.3 per cent). It was over four times as high for children aged 10-11 years living in the most deprived areas (9.4 per cent) than the least deprived areas (2.1 per cent).

Some key differences were observed between various groups. For instance, the prevalence of children living with obesity in 2021-22 was highest for Black children in both reception (16.2 per cent) and Year 6 (33.0 per cent); it was lowest for children of a Chinese descent in both reception (4.5 per cent) and Year 6 (17.7 per cent). Moreover, boys had a higher prevalence of living with obesity than girls for both age groups.

Although these figures are smaller compared to those discovered last year in 2020-2021, they continue to concern health and care professionals as they remain higher than pre-pandemic levels.

Integrated care systems: reaching disenfranchised communities

By Raj Purewal

Raj Purewal, UK&I Strategic Development Director at Tunstall Healthcare, discusses how technology can be adopted by integrated care systems (ICSs), and how care services can reach all communities and reduce health inequalities.

In October, Public Policy Projects (PPP) launched its ICS Roadshow in locations across the UK. The events endeavour to bring together health, social care and housing professionals and create a new forum for integrated care, which sees national policy delivered at a local level.

Setting the strategy with ICSs

ICSs have taken over the role of Clinical Commissioning Groups, who were previously responsible for commissioning the best health services for their localities. ICSs will also be responsible for implementing strategies across footprints to ensure patients and citizens can access the best services and care possible. They will be able to link the data and insight they have access to from the daily activities of the health and care sector, ultimately transforming the way care services are provided.

The integration of health and social care services will be a key enabler in the transformation of systems for citizens. ICSs, alongside local authorities, will be the driving force behind this as they have been specifically designed as the link between health and social care to improve collaboration, care provision and patient outcomes.

ICSs have also been tasked with ensuring the continuity of care in regions across England, so that national policy aligns with the needs of patients and citizens on a local level. The introduction of new legislation will direct local and regional health and care systems to improve alignment between service providers, while supporting, enabling and educating patients, and when appropriate, to manage their needs.

Tunstall is at a pivotal place when it comes to aligning services through ICSs and it’s crucial that we adapt our strategies as required. Tunstall’s services must support ICSs’ objectives and their focus on driving best practice, transforming services and increasing the use of digital capabilities for patients and citizens.

ICSs will foster closer working between health and care service providers. Tunstall’s longstanding role and remit shall continue, and we will also support providers, commissioners, partners and vendors to deliver the Triple Aim, ROI and best value for these sectors and the public sector pound.

Adopting technology

The importance of technology in service delivery across the health and care sectors shouldn’t be underestimated, particularly when it comes to monitoring and assessing citizens and patients when discharged, or in virtual wards, and when appropriate, pro-actively before a planned attendance. To adopt technology-enabled care services, we must help to educate both citizens and health and care professionals effectively, and leaders must coordinate this across ICSs.

Adopting and scaling the right technology will support many resources, increase utilisation, and improve capacity across the health and care systems, to provide effective care. ICSs will continue to increase the focus on building preventative and proactive care models, which will include investment in the continued advancement of technology.

Technology providers are working on solutions and platforms that will identify changes in patients’ or citizens’ vital signs, mobility or behaviour. For example, Tunstall Cognitive Care® will use advanced AI in combination with technology in the home to detect whether someone’s health could be about to deteriorate, spot a potentially undiagnosed condition, or resolve an immediate social care need.

Since before the pandemic, around 22 per cent of the NHS elective backlog for surgery is for orthopaedic conditions relating to the hip or knee, or cataract surgery; patients who are on these waiting lists can be identified and supported with remote monitoring. For example, if a particular behavioural trend for a citizen who is struggling with mobility can be seen, support can be offered quickly with an appropriate intervention at the right time to minimise the need for urgent, more expensive unplanned emergency care. This type of integration and use of technology will help to reduce stress and pressure on provider resources and service work plans.

As ICSs transform services, and move towards digitisation and digitalisation, the technology that providers deploy needs to facilitate strong foundations for the future of care provision, as ICSs will aim to optimise data and to generate insight. In helping to ensure that the infrastructure and systems are in place, Tunstall can start to have positive impacts on health and care services for all as health care services make these transitions.

Improving care services and reaching all communities

The overall experience of services for all citizens should be improved through the introduction of ICSs, as they will be tasked to ensure equality of care, which historically has not always been the case.

ICSs will also increase focus on improving value delivered for the public purse, improving efficiency by reducing the incidence of unattended appointments (DNAs) and ensuring a continuum of care for the patient and citizen from referral and after discharge. This is critical in ensuring healthcare services are optimised – ranging from effective patient communication, reducing the number of DNAs, and sharing insight with practitioners to inform best practice. ICSs will be able to take an analytical approach to the data they have access to and use this to both inform planning and to allocate resources.

To reduce health inequalities, it will be necessary to take a holistic view. For example, poor housing can have an impact on citizen health if there is a lack of insulation or if there is damp. There is no singular factor or reason that causes health inequality, but ICSs will bring bespoke approaches for their different localities to ensure gaps in health and care are lessened and minimised over time.

Other inequalities can cause communities to become disenfranchised with service providers, for example problems can arise because of travel, logistics and even linguistic challenges. Most recently, we saw an example of this as some communities were excluded from pandemic communications especially digital communications, including the messaging around measures put in place to reduce the spread of COVID-19.

The establishment and progression of ICSs will enable the alignment of technology-based health and social care services and improve health outcomes for every community across the UK.

As service providers and the workforce become increasingly invested in, and understanding of, the role of technology in supporting and empowering vulnerable people, we’ll see a reduction in health inequalities and upgraded services that are better able to meet the demands of our growing and ageing population.

Tunstall Healthcare launches tech hub in Manchester

By Integrated Care Journal

Global pioneering health and care technology firm Tunstall Healthcare has officially opened its new hub in St Peter’s Square, Manchester.

Tunstall Healthcare, which is celebrating its 65th year, is currently recruiting for a range of hybrid working positions that will be based in the new hub in St Peter’s Square, Manchester. Quality and testing, software development and business analysis roles are available to complement the existing tech teams based in Yorkshire, Sweden, Germany and Spain.

As well as mid-senior tech roles, there will be opportunities for graduates and apprentices to join the firm as part of Tunstall’s drive to mentor and train the very best talent in tech, in addition to positions that will offer support to those who wish to retrain or who have been out of work.

Emil Peters, Tunstall Group CEO at Tunstall, said: “This is undoubtedly a huge and exciting milestone for Tunstall as we open our latest UK office space, in the renowned business and technology hub of Manchester. Our new base is the perfect location to serve our customers across the country and in the north west, as well as attracting new talent to the Tunstall brand.

“A career at Tunstall gives candidates the opportunity to make a real difference in the health and care sector by realising the potential of technology to empower people to have more choice over how they live their lives. Our Manchester base will help us to attract some of the brightest talent in the sector to help us drive our exciting technology roadmap forward, and I’m looking forward to welcoming new colleagues to the business.”

Established in 1957, Tunstall has grown substantially and evolved from an equipment provider to a software solution and technology company that provides telecare and telehealth managed services. In this time, it has almost doubled the number of users supported by its systems, while increasing its geographic footprint across Europe.

Gary Steen, Chief Operating Officer at Tunstall UK, added: “At Tunstall, we put our people first and invest in their professional development. By expanding our base across the North, we will be able to continue our success as a business while forging ahead as the market leader in our sector.

“New technology solutions are vital if we are to support our ageing population effectively. Innovation and development in the health and care sector will allow us to continue moving towards a proactive and preventative model of care provision which improves the quality of people’s lives and enables valuable resource to be targeted where and when they are needed most.”

Tunstall Group works with health, care and housing providers around the world and supports more than five million people through technology. Its technology and service offerings allow its customers to deploy new models of community-based health and care delivery that are more integrated, personalised and proactive.

To find out more about Tunstall, please visit www.tunstall.co.uk.

Integrated care and service transformation – the role of experience

By Emil Peters

Emil Peters, Group CEO at Tunstall Healthcare, discusses the role of experience for all stakeholders within the health and social care systems, and how ICSs will enable improvements to care provision and delivery for all.

When it comes to the transformation of health and care services, there have been numerous iterations of reforms. The current implementation of Integrated Care Systems (ICSs) and Integrated Care Boards (ICBs) in my view, presents an opportunity to truly transform our services and become a global leader within the health and care landscape.

However, it is important to remember that there are still key issues that need to be addressed at the heart of the health and social care landscape if we’re going to innovate and improve the care that health systems are able to provide the population. Addressing the concerns of all stakeholders, from users and residents to professionals and leaders in health and social care, and where technology sits within this, will give us a good chance of working with ICSs to create a landscape that is able to effectively serve everyone.

Experience is key

Experience matters, but not only in the traditional sense. While there are many key facets involved in the development and transformation of services, the experiences of patients, the workforce, and the entire community are crucial. If we align with these stakeholders and their lived experiences, we can begin to change the health and social care landscape.

Identifying the needs of each individual, and understanding that every population is made up of a set of people, will make it easier to deliver better services. If the entire ecosystem works in harmony, citizens will receive better care and their outcomes will be improved. It’ll also mean that health systems are better equipped to meet the expectations of the population when it comes to care delivery.

It will also be essential to keep the experiences of the workforce, from challenges to working practices, at the forefront. If we can meet the various needs of professionals, it will be easier to engage with them, and they will be more open to trying and deploying new solutions and services, such as technology. Ultimately, if professionals are cared for first, the care of citizens is likely to be improved in a consistent and sustainable way. While professionals keep in mind the compensated workforce, must also include the voluntary sector as a vital cog in our ability to deliver the lived experience we all want.

By working together, the health system will be better equipped to navigate care provision for residents and the community when it is required. We’ll know what the care is going to look like, how we’re going to deliver it, and communicate to service users what they can expect. This in turn will give them the information they need to become empowered and able to make the best decisions for themselves. As people become more empowered and involved in their own health, wellbeing and care provision, their outcomes are much more likely to improve.

Experience and technology

Technology has a key part to play in enabling the UK to become a global leader in the health and social care space, but a holistic view which looks beyond technology on its own is vital. While digital solutions have the ability to become sustainable if done right, focusing on how users interact with technology will also be crucial.

Regardless of the huge range of technology that is available and the incredible features that it can provide, it’s the people involved who will enable the true potential of digital solutions to be reached. If the experience of users and caregivers with technology is subpar, it’ll be difficult to deliver digital solutions that are sustainable and impactful.

When it comes to the public’s perceptions of the nation’s health services, many people consider the different levels and organisations of health and care in the UK to be effectively joined up, rather than the reality where many are working in silo. Investing in technology will enable an environment where the workforce can share vital information, communicate effectively and provide better care for residents. This in turn will create better outcomes for everyone involved and will promote care that is tailored to every individual within the care system, whether it be a nurse, a patient, or a family member.

The more that professionals are able to engage with digital solutions, the more that their time will be freed up to listen to the people that they care for. Patients and service users are very aware of the care that they are receiving, particularly when it comes to the small things, and technology can help to change their perception in a positive way.

Integrated care systems and their role

It’s important that stakeholders look beyond the monetary gains that can be achieved through the successful implementation and integration of ICSs and ICBs. If service transformation is viewed solely through the lens of finance, it’s easy to forget about the people and stakeholders who actually make the transformation possible and how they can be engaged.

ICSs can help us to involve all people from the top down, and provide the tools that to support everyone and deliver proactive and preventative care. Both the health and social care services are ultimately caring industries, with the majority of professionals working within them to support the health and wellbeing of communities through effective care provision.

ICSs are also giving us the opportunity to work with groups beyond the immediate health and social care sectors that are still able to have a significant impact on the health and wellbeing of residents. For many, good health begins in the community, and so if ICSs can engage with organisations and places such as public libraries, this will lead to better care across the board. It’s also important to focus more on upstream interventions and maintaining wellbeing to reduce the pressures on acute services and promote good health.

ICSs have provided a unique opportunity to merge the health and social care workforce across the spectrum, and optimise the experience of these professionals. The improved collaborations through ICSs should also support a reduction in the fear of the workforce when it comes to adopting new products and services, such as technology, and working closely together to embed them into new models of care. Collaboration will be key to supporting an improvement in the lived experiences of the populations we serve.

This article was kindly sponsored by Tunstall Healthcare.

For more information, please visit www.tunstall.co.uk.